Association of gestational thyroid function and thyroid peroxidase antibody positivity with postpartum depression: a prospective cohort study and systematic literature review with meta-analysis
Authors' conclusion
There was no significant association of TPOAb positivity, TSH, or FT4 with PPD. Our systematic review and meta-analysis revealed high heterogeneity of the current literature. Although TPOAb-positive women should be monitored for postpartum thyroiditis, our findings do not support routinely screening for PPD.
Study context
- Population
- Pregnant women with thyroid stimulating hormone (TSH), free thyroxine (FT4) and thyroid peroxidase antibody (TPOAb) measured at 9–17 weeks' gestation
- Comparison
- TPOAb positivity and thyroid function vs PPD
- Outcome
- PPD by Edinburgh Postpartum Depression Scale (2 months postpartum) and Brief Symptom Inventory (2, 6 and 36 months postpartum)
Methodological detailspopulation-based
- Population-based
Pooled result
As reported in the abstract
Association with PPD (cohort)
Odds ratio (95% CI)P value
TSH
0.83(0.58–1.19)
P = 0.32FT4
0.99(0.95–1.05)
P = 0.86TPOAb positivity
0.79(0.47–1.33)
P = 0.37Further pooled results
Meta-analysis: TPOAb positivity and PPD
| OR (95% CI) | P value | ||
|---|---|---|---|
| TPOAb positivityI2 = 79% · heterogeneous results | 1.93 (0.91–4.10) | P = 0.08 | |
| 0.20.5125Odds ratio (log scale) |
- Meta-analysis: TPOAb positivity and PPD: 3 articles combined with present study
Impaired thyroidal response to human chorionic gonadotropin (hCG) (surrogate for TPOAb positivity) and PPD
- Associated with lower risk of PPD
- P for interaction TSH = 0.04; FT4 = 0.06
Original publication
Association of gestational thyroid function and thyroid peroxidase antibody positivity with postpartum depression: a prospective cohort study and systematic literature review with meta-analysis. Eur J Endocrinol. Published 24 July 2023. doi:10.
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